PMID- 34916161
OWN - NLM
STAT- MEDLINE
DCOM- 20220404
LR  - 20220509
IS  - 1878-0539 (Electronic)
IS  - 1748-6815 (Linking)
VI  - 75
IP  - 3
DP  - 2022 Mar
TI  - Comparing post-surgical outcomes of pre-pectoral versus dual-plane 
      direct-to-implant breast reconstruction without increasing the use of acellular 
      dermal matrix.
PG  - 1123-1129
LID - S1748-6815(21)00564-7 [pii]
LID - 10.1016/j.bjps.2021.11.017 [doi]
AB  - BACKGROUND: Direct-to-implant (DTI) reconstruction when performed using the 
      dual-plane technique can be associated with increased postoperative pain, longer 
      recovery, functional impairment, and animation deformity. These issues can be 
      avoided by using the pre-pectoral technique that traditionally uses larger pieces 
      of the acellular dermal matrix (ADM) and results in increased costs. It is 
      unclear how these two methods compare when the technique is modified to avoid the 
      use of additional ADM. METHODS: A retrospective chart review was conducted of all 
      patients who underwent DTI breast reconstruction using a dual-plane or 
      pre-pectoral technique between January 2014 and December 2019. Pre-pectoral 
      breast reconstruction was performed using a partial anterior coverage technique, 
      and therefore no additional ADM was used per case as compared to the dual-plane 
      technique. Rates of post-surgical complications were compared between the two 
      groups. RESULTS: Of 77 patients, 48 (86 breasts) underwent dual-plane 
      reconstruction, whereas 29 (48 breasts) underwent pre-pectoral reconstruction. 
      Mean follow-up time for the dual-plane and pre-pectoral groups was 23.3 and 8.7 
      months, respectively (p<0.001). There were no significant differences in the 
      rates of any of the short-term post-surgical outcomes between the two groups: 
      seroma (14% vs 6.3%, p = 0.175); hematoma (2.3% vs 4.2%, p = 0.617); skin/nipple 
      necrosis (7% vs 10.4%, p = 0.522); wound skin infection (2.3% vs 2.1%, p = 1.0); 
      wound dehiscence (4.7% vs 2.1, p = 0.654); and implant loss (1.2% vs 8.3%, 
      p = 0.055). CONCLUSIONS: Pre-pectoral reconstruction using a partial anterior 
      coverage technique appears to be a safe alternative to dual-plane reconstruction 
      when considering short-term post-surgical complications.
CI  - Copyright (c) 2021 Elsevier Ltd. All rights reserved.
FAU - Patel, Ruchit
AU  - Patel R
AD  - School of Medicine, Queen's University, Kingston, Ontario, Canada.
FAU - Somogyi, Ron B
AU  - Somogyi RB
AD  - Division of Plastic, Reconstructive and Aesthetic Surgery, University of Toronto, 
      Toronto, Ontario, Canada. Electronic address: drsomogyi@formfacebody.ca.
LA  - eng
PT  - Journal Article
DEP - 20211114
PL  - Netherlands
TA  - J Plast Reconstr Aesthet Surg
JT  - Journal of plastic, reconstructive & aesthetic surgery : JPRAS
JID - 101264239
SB  - IM
MH  - *Acellular Dermis
MH  - *Breast Implantation/methods
MH  - *Breast Implants
MH  - *Breast Neoplasms/surgery
MH  - Female
MH  - Humans
MH  - *Mammaplasty/methods
MH  - Mastectomy/methods
MH  - Nipples
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Acellular dermal matrix
OT  - Direct-to-implant reconstruction
OT  - Dual plane
OT  - Immediate breast reconstruction
OT  - Pre-pectoral
EDAT- 2021/12/18 06:00
MHDA- 2022/04/05 06:00
CRDT- 2021/12/17 05:51
PHST- 2021/02/21 00:00 [received]
PHST- 2021/11/03 00:00 [revised]
PHST- 2021/11/06 00:00 [accepted]
PHST- 2021/12/18 06:00 [pubmed]
PHST- 2022/04/05 06:00 [medline]
PHST- 2021/12/17 05:51 [entrez]
AID - S1748-6815(21)00564-7 [pii]
AID - 10.1016/j.bjps.2021.11.017 [doi]
PST - ppublish
SO  - J Plast Reconstr Aesthet Surg. 2022 Mar;75(3):1123-1129. doi: 
      10.1016/j.bjps.2021.11.017. Epub 2021 Nov 14.